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虚拟触诊组织定量分析在特发性肾病综合征肾病理评估中的应用

Virtual Touch Tissue Quantification for Assessing Renal Pathology in Idiopathic Nephrotic Syndrome.

作者信息

Yang Xue, Yu Ning, Yu Jing, Wang Hongqiao, Li Xiumei

机构信息

Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.

Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.

出版信息

Ultrasound Med Biol. 2018 Jul;44(7):1318-1326. doi: 10.1016/j.ultrasmedbio.2018.02.012. Epub 2018 Apr 9.

Abstract

The aim of this study was to evaluate Virtual Touch tissue quantification in assessing renal interstitial fibrosis in patients with idiopathic nephrotic syndrome. Ninety patients with idiopathic nephrotic syndrome were assigned to mild, moderate and severe groups depending on the degree of renal interstitial fibrosis on histopathologic examination of renal biopsy specimens. Thirty healthy patients were also selected as the control group. Virtual Touch tissue quantification was performed to measure the shear wave velocity of the renal parenchyma. There was no statistically significant difference in shear wave velocity between the mild and control groups (p > 0.05); however, the moderate and severe groups did significantly differ compared with the control (p <0.001). The area under the receiver operating characteristic curve value for the shear wave velocity of renal interstitial fibrosis in the moderate group versus the control and mild groups together was 0.869 (95% confidence interval: 0.791-0.947) and that in the severe group versus the control, mild and moderate groups together was 0.954 (95% confidence interval: 0.917-0.998). The corresponding best cutoff points were 2.41 and 2.77 m/s, with sensitivities of 91.7% and 86.8%, specificities of 78.0% and 92.0%, negative predictive values 0.907 and 0.907, positive predictive values 0.800 and 0.971 and Youden index values of 0.697 and 0.788, respectively. Virtual Touch tissue quantification may non-invasively and quantitatively estimate the degree of renal interstitial fibrosis in patients with idiopathic nephrotic syndrome as a baseline for monitoring progression and treatment response.

摘要

本研究旨在评估虚拟触诊组织定量技术在评估特发性肾病综合征患者肾间质纤维化中的应用。根据肾活检标本组织病理学检查的肾间质纤维化程度,将90例特发性肾病综合征患者分为轻度、中度和重度组。另外选取30例健康患者作为对照组。采用虚拟触诊组织定量技术测量肾实质的剪切波速度。轻度组与对照组之间的剪切波速度无统计学显著差异(p>0.05);然而,中度和重度组与对照组相比有显著差异(p<0.001)。中度组肾间质纤维化剪切波速度与对照组和轻度组联合相比,受试者工作特征曲线下面积值为0.869(95%置信区间:0.791 - 0.947),重度组与对照组、轻度组和中度组联合相比为0.954(95%置信区间:0.917 - 0.998)。相应的最佳截断点分别为2.41和2.77m/s,灵敏度分别为91.7%和86.8%,特异度分别为78.0%和92.0%,阴性预测值分别为0.907和0.907,阳性预测值分别为0.800和0.971,约登指数值分别为0.697和0.788。虚拟触诊组织定量技术可作为一种非侵入性定量评估特发性肾病综合征患者肾间质纤维化程度的方法,作为监测疾病进展和治疗反应的基线。

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